Music4Libraries

Student's Full Name (required)

Student's Grade Level (25-26 School Year) (required)

4th Grade

5Th Grade

Parent/Guardian Full Name (required)

Parent/Guardian Email Address (required)

Parent/Guardian Phone Number (required)

Does your child have previous experience with music? No former experience is necessary.

Yes

No

If yes, what kind of music experience do they have? (i.e. choir, plays an instrument, makes their own music/beats, etc.)

How would you rate your child's current interest in music? 1 being the lowest and 5 the highest

Is your child a student Harlean Beal?

Yes

No

If student at Harlean Beal, which session will your student attend?

Wednesday after school 3:30-4:15pm

Saturday 12:12:45pm

If your child does not attend Harlean Beal, please select the option below:

Saturday 12 - 12:45pm

Do you give permission for your child to be photographed or videoed during the program for the Forest Hill Public Library's & Music4 Libraries Project's promotional purposes? (required)

Yes

No

By typing your name here, you are acknowledging you and your child's commitment for the 6 week program: (required)

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